MEDICARE: DR. WALTER NEIL SIMMONS M.D., MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	210645	MA
2	207P00000X	Emergency Medicine Physician	29610	AZ

General Provider Information

NPI Number	:	1023087293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER NEIL SIMMONS M.D., MPH

Provider Business Mailing Address
First Line	:	10320 W MCDOWELL RD
Second Line	:	SUITE N1444
City	:	AVONDALE
State	:	AZ
Zip	:	85392-4863
Country	:	US
Telephone Number	:	480-398-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	10320 W MCDOWELL RD
Second Line	:	SUITE N1444
City	:	AVONDALE
State	:	AZ
Zip	:	85392-4863
Country	:	US
Telephone Number	:	866-888-7078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	02/09/2015

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